Medical Journal Articles Research Articles

Standardized application and considerations of charts in medical journal articles

Standardized application and considerations of charts in medical journal articles

Efficacy of Medical Student Surgery Journal Club

Journal clubs exist in a variety of forms in medical schools across the United States. Many incorporate a full spectrum of medical specialties, some are specific to certain interest groups or specialties, and many widely vary in whether or not they are school mandated or student-run. While these clubs are ubiquitously scattered throughout medical education, there has been very little quantitative or qualitative analysis regarding the efficacy of these clubs in enhancing medical students' abilities to evaluate clinical literature. The purpose of this study was to evaluate the effects of attending Surgical Journal Club meetings at Eastern Virginia Medical School from both a qualitative and quantitative perspective. The authors' hypothesis was that regular attendance of these sessions would improve student performance from a multitude of perspectives and demonstrate the value of clinical literature analysis earlier in medical education. A fifteen question Likert survey was administered on an optional basis to thirty-six medical students attending journal club. Responses were analyzed anonymously, and there was no incentive or demerit for completing the survey. Data was compiled and the mean, median, and mode for each question calculated with "5" corresponding to "Strongly Agree" and "1" corresponding to "Strongly Disagree." Twenty-seven of thirty-six attendees to our seventh journal club meeting completed the survey. Student responses were overwhelming positive, with all but one question reaching above "Agree" by analysis of the mean responses. Journal clubs remain an integral part of medical education but their importance has been diminished in recent years due to the increasing demands of other aspects of the first two years in medical school. We described a medical student run/established journal club that increased students' interest in surgery, their perceived knowledge-base, and comfort in critically analyzing medical journal articles.

Physicians Are People, TooAlso Human: The Inner Lives Of Doctors By Caroline Elton New York (NY): Basic Books, 2018 336 pp., $30.00

Physicians Are People, TooAlso Human: The Inner Lives Of Doctors By Caroline Elton New York (NY): Basic Books, 2018 336 pp., $30.00

Conflicts of interest and industry professional relationships in psychiatric neurosurgery: a comparative literature review.

OBJECTIVE The research required to establish that psychiatric treatments are effective often depends on collaboration between academic clinical researchers and industry. Some of the goals of clinical practice and those of commercial developers of psychiatric therapies overlap, such as developing safe and effective treatments. However, there might also be incompatible goals; physicians aim to provide the best care they can to their patients, whereas the medical industry ultimately aims to develop therapies that are commercially successful. In some cases, however, clinical research may be aiming both at improved patient care and commercial success. It is in these cases that a conflict of interest (COI) arises. The goal of this study was to identify differences and commonalities regarding COIs between 2 kinds of somatic psychiatric interventions: pharmacological and neurosurgical. METHODS The authors conducted a study focused on professional concerns regarding pharmacological and neurosurgical psychiatric interventions. They used medical and bioethics journal articles as an indicator of professionals' concerns and carried out a thematic content analysis of peer-reviewed articles published between 1960 and 2015, using PubMed and Google Scholar. RESULTS One hundred thirty-seven relevant articles were identified, of which 86 papers focused primarily on psychopharmacology and 51 on neurosurgery. The intervention most discussed in the psychiatric neurosurgery data set was deep brain stimulation (n = 42). While there were no significant differences at the level of categories, pharmacological and neurosurgical interventions differ in the underlying themes discussed. Two issues widely discussed in the articles on pharmaceutical interventions, but largely neglected in the neurosurgery articles, were medical professional issues and industry involvement. CONCLUSIONS COIs are a neglected issue in the discussion of ethics concerns regarding medical devices in psychiatry. Yet as these interventions become more common, it is important to address them in part through learning from the discussion regarding COIs in the pharmaceutical industry and by developing approaches to address those aspects of COIs that are unique to the medical device industry.

Randomization: The forgotten component of the randomized clinical trial.

"…The customary test for an observed difference…is based on an enumeration of the probabilities, on the initial hypothesis that two treatments do not differ in their effects,…of all the various results which would occur if the trial were repeated indefinitely with different random samples of the same size as those actually used." -Peter Armitage ("Sequential tests in prophylactic and therapeutic trials" in Quarterly Journal of Medicine, 1954;23(91):255-274). Randomization has been the hallmark of the clinical trial since Sir Bradford Hill adopted it in the 1946 streptomycin trial. An exploration of the early literature yields three rationales, ie, (i) the incorporation of randomization provides unpredictability in treatment assignments, thereby mitigating selection bias; (ii) randomization tends to ensure similarity in the treatment groups on known and unknown confounders (at least asymptotically); and (iii) the act of randomization itself provides a basis for inference when random sampling is not conducted from a population model. Of these three, rationale (iii) is often forgotten, ignored, or left untaught. Today, randomization is a rote exercise, scarcely considered in protocols or medical journal articles. Yet, the literature of the last century is rich with statistical articles on randomization methods and their consequences, authored by some of the pioneers of the biostatistics and statistics world. In this paper, we review some of this literature and describe very simple methods to rectify some of the oversight. We describe how randomization-based inference can be used for virtually any outcome of interest in a clinical trial. Special mention is made of nonstandard clinical trials situations.

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Agreement Analysis: What He Said, She Said Versus You Said.

Correlation and agreement are 2 concepts that are widely applied in the medical literature and clinical practice to assess for the presence and strength of an association. However, because correlation and agreement are conceptually distinct, they require the use of different statistics. Agreement is a concept that is closely related to but fundamentally different from and often confused with correlation. The idea of agreement refers to the notion of reproducibility of clinical evaluations or biomedical measurements. The intraclass correlation coefficient is a commonly applied measure of agreement for continuous data. The intraclass correlation coefficient can be validly applied specifically to assess intrarater reliability and interrater reliability. As its name implies, the Lin concordance correlation coefficient is another measure of agreement or concordance. In undertaking a comparison of a new measurement technique with an established one, it is necessary to determine whether they agree sufficiently for the new to replace the old. Bland and Altman demonstrated that using a correlation coefficient is not appropriate for assessing the interchangeability of 2 such measurement methods. They in turn described an alternative approach, the since widely applied graphical Bland-Altman Plot, which is based on a simple estimation of the mean and standard deviation of differences between measurements by the 2 methods. In reading a medical journal article that includes the interpretation of diagnostic tests and application of diagnostic criteria, attention is conventionally focused on aspects like sensitivity, specificity, predictive values, and likelihood ratios. However, if the clinicians who interpret the test cannot agree on its interpretation and resulting typically dichotomous or binary diagnosis, the test results will be of little practical use. Such agreement between observers (interobserver agreement) about a dichotomous or binary variable is often reported as the kappa statistic. Assessing the interrater agreement between observers, in the case of ordinal variables and data, also has important biomedical applicability. Typically, this situation calls for use of the Cohen weighted kappa. Questionnaires, psychometric scales, and diagnostic tests are widespread and increasingly used by not only researchers but also clinicians in their daily practice. It is essential that these questionnaires, scales, and diagnostic tests have a high degree of agreement between observers. It is therefore vital that biomedical researchers and clinicians apply the appropriate statistical measures of agreement to assess the reproducibility and quality of these measurement instruments and decision-making processes.

Phenotype Instance Verification and Evaluation Tool (PIVET): A Scaled Phenotype Evidence Generation Framework Using Web-Based Medical Literature.

BackgroundResearchers are developing methods to automatically extract clinically relevant and useful patient characteristics from raw healthcare datasets. These characteristics, often capturing essential properties of patients with common medical conditions, are called computational phenotypes. Being generated by automated or semiautomated, data-driven methods, such potential phenotypes need to be validated as clinically meaningful (or not) before they are acceptable for use in decision making.ObjectiveThe objective of this study was to present Phenotype Instance Verification and Evaluation Tool (PIVET), a framework that uses co-occurrence analysis on an online corpus of publically available medical journal articles to build clinical relevance evidence sets for user-supplied phenotypes. PIVET adopts a conceptual framework similar to the pioneering prototype tool PheKnow-Cloud that was developed for the phenotype validation task. PIVET completely refactors each part of the PheKnow-Cloud pipeline to deliver vast improvements in speed without sacrificing the quality of the insights PheKnow-Cloud achieved.MethodsPIVET leverages indexing in NoSQL databases to efficiently generate evidence sets. Specifically, PIVET uses a succinct representation of the phenotypes that corresponds to the index on the corpus database and an optimized co-occurrence algorithm inspired by the Aho-Corasick algorithm. We compare PIVET’s phenotype representation with PheKnow-Cloud’s by using PheKnow-Cloud’s experimental setup. In PIVET’s framework, we also introduce a statistical model trained on domain expert–verified phenotypes to automatically classify phenotypes as clinically relevant or not. Additionally, we show how the classification model can be used to examine user-supplied phenotypes in an online, rather than batch, manner.ResultsPIVET maintains the discriminative power of PheKnow-Cloud in terms of identifying clinically relevant phenotypes for the same corpus with which PheKnow-Cloud was originally developed, but PIVET’s analysis is an order of magnitude faster than that of PheKnow-Cloud. Not only is PIVET much faster, it can be scaled to a larger corpus and still retain speed. We evaluated multiple classification models on top of the PIVET framework and found ridge regression to perform best, realizing an average F1 score of 0.91 when predicting clinically relevant phenotypes.ConclusionsOur study shows that PIVET improves on the most notable existing computational tool for phenotype validation in terms of speed and automation and is comparable in terms of accuracy.

Looking to the future of nasal drug delivery - an interview with Per Gisle Djupesland.

Per G Djupesland, MD, PhD speaks to Hannah Makin, Commissioning Editor: Dr Djupesland is the inventor of OptiNose®'s patented, bi-directional nasal drug-delivery technology and is a Co-Founder of OptiNose AS. Dr. Djupesland is a lead inventor on all 38 OptiNose patent families/patent applications, and serves as Chief Scientific Officer of OptiNose AS, with primary responsibility for device discovery and early development efforts. These early development efforts include identifying new product opportunities that use bi-directional technology, advancing the design of devices using the bi-directional technology to treat a variety of medical conditions and conducting Phase I and IIa trials with new 'nose-to-brain' applications for the technology. Dr Djupesland is an otolaryngologist (ENT) with a specialization in rhinology and more than 25years of clinical experience. Among other positions prior to OptiNose, he served as a Clinical Research Fellow at the Hospital for Sick Children and Toronto General in Toronto, Canada, primarily studying the role of nitric oxide in the upper airways. Dr Djupesland has authored more than 60 peer reviewed articles in international medical journals and has lectured at numerous international scientific conferences. He earned medical and doctorate degrees in the field of nasal physiology and aerodynamics from the University of Oslo.

Publication patterns on occupied Palestine in four key medical journals 1990–2016: a descriptive study

BackgroundThe atrocities in Syria have been covered in the four general medical weekly journals in the USA and the UK. Medical journal articles addressing political determinants of public health have rightly described and criticised the international community's failure to enforce humanitarian law while urging global bodies of power to ensure protection of civilians and civilian infrastructure and medical services. Discussions of the political influences on health of people in the occupied Palestinian territory (West Bank and Gaza Strip) seem to be considered politically out-of-bounds by some medical journals. This study used a keyword-based search to explore patterns of publication about the occupied Palestinian territory and Israel by four large US and European medical journals. MethodThe four highest ranked, peer-reviewed, international medical journals were searched: The Journal of the American Medical Association (JAMA), The New England Journal of Medicine (NEJM), The Lancet, and The British Medical Journal (BMJ). Searches were conducted between Sept 1 and Sept 6, using each journal's search engine with the keywords “Gaza”, “West Bank” and the stems “Palestin*” and “Israel*” in all fields for the period Jan 1, 1990, to Sept 6, 2016. News and commentary articles were included in the findings. FindingsThe searches found the term “Palestin*” in 49 articles from the two US journals (32 in JAMA; 17 in NEJM) and 694 articles in the two UK journals (236 in The Lancet; 458 in BMJ). “Israel*” was found in 840 articles in US journals (386 in JAMA; 454 in NEJM) and in 2972 articles in UK journals (1388 in The Lancet; 1584 in BMJ). “West Bank” was found in nine articles in US journals (nine in JAMA; none in NEJM) and in 297 articles from the UK (211 in The Lancet; 86 in BMJ). “Gaza” was found in 18 articles in US journals (15 from JAMA; three from NEJM) and in 487 articles in UK journals (324 in The Lancet; 166 in BMJ). InterpretationCompared with the two US-based medical journals, the UK journals published substantially more articles with the relevant keywords and discussed political responsibilities for the dire health conditions experienced by the Palestinian people. The journals included in this study differed in the extent to which they featured news and comments, which might have affected the number of published articles. Because there is a larger research establishment in Israel than in the West Bank and the Gaza Strip, the keyword “Israel” might have been included in a larger number of clinical and biomedical scientific papers. Medical leaders, including journal editors, have a responsibility to participate in the discussion around this preventable situation, which could have long-lasting public health consequences. FundingNone.

Prevalence of Disclosed Conflicts of Interest in Biomedical Research and Associations With Journal Impact Factors and Altmetric Scores

This study estimates the prevalence of conflict of interest disclosures in medical journal articles published in 2016 and associations between disclosures and median journal impact factor and article Altmetric scores.

Discrepancies among Scopus, Web of Science, and PubMed coverage of funding information in medical journal articles.

ObjectiveThe overall aim of the present study was to compare the coverage of existing research funding information for articles indexed in Scopus, Web of Science, and PubMed databases.MethodsThe numbers of articles with funding information published in 2015 were identified in the three selected databases and compared using bibliometric analysis of a sample of twenty-eight prestigious medical journals.ResultsFrequency analysis of the number of articles with funding information showed statistically significant differences between Scopus, Web of Science, and PubMed databases. The largest proportion of articles with funding information was found in Web of Science (29.0%), followed by PubMed (14.6%) and Scopus (7.7%).ConclusionThe results show that coverage of funding information differs significantly among Scopus, Web of Science, and PubMed databases in a sample of the same medical journals. Moreover, we found that, currently, funding data in PubMed is more difficult to obtain and analyze compared with that in the other two databases.

The coordination of plural logics of action and its consequences: Evidence from plural medical systems.

Drawing on the theory of social action in organizational and institutional sociology, this paper examines the behavioral consequences of plural logics of action. It addresses the question based on the empirical case of plural medical systems that are composed of both biomedicine and alternative medicine. Applying mixed methods of a cross-national panel data analysis and a content analysis of medical journal articles, it finds that plural systems affect health outcomes negatively when tensions between biomedicine and alternative medicine are unaddressed. In contrast, plural systems produce tangible health benefits when biomedicine and alternative medicine are coordinated through government policies or by health care organizations/professionals. This paper proposes plurality coordination as an important mechanism that modifies the behavioral consequences of plural logics. This proposition contributes to providing theoretical answers to the sociological puzzle that plural logics of action produce inconsistent behavioral consequences.

Childbirth and Trauma, 1940s-1980s.

This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history.

Quality of reporting and risk of bias in therapeutic otolaryngology publications.

High-quality trials have the potential to influence clinical practice. Ten otolaryngology journals with the highest 2011 impact factors were selected and publications from 2010 were extracted. From all medical journals, the 20 highest impact factor journals were selected, and publications related to otolaryngology for 2010 and 2011 were extracted. For all publications, the reporting quality and risk of bias were assessed. The impact factor was 1.8-2.8 for otolaryngology journals and 6.0-101.8 for medical journals. Of 1500 otolaryngology journal articles, 262 were therapeutic studies; 94 had a high reporting quality and 5 a low risk of bias. Of 10 967 medical journal articles, 76 were therapeutic studies; 57 had a high reporting quality and 8 a low risk of bias. Reporting quality was high for 45 per cent of otolaryngology-related publications and 9 per cent met quality standards. General journals had higher impact factors than otolaryngology journals. Reporting quality was higher and risk of bias lower in general journals than in otolaryngology journals. Nevertheless, 76 per cent of articles in high impact factor journals carried a high risk of bias. Better reported and designed studies are the goal, with less risk of bias, especially in otolaryngology journals.

An Analysis of Trends in Medical Journal Articles of Botanical Drugs in North Korea

An Analysis of Trends in Medical Journal Articles of Botanical Drugs in North Korea

Conference presentation to publication: a retrospective study evaluating quality of abstracts and journal articles in medical education research

BackgroundThere is little evidence regarding the comparative quality of abstracts and articles in medical education research. The Medical Education Research Study Quality Instrument (MERSQI), which was developed to evaluate the quality of reporting in medical education, has strong validity evidence for content, internal structure, and relationships to other variables. We used the MERSQI to compare the quality of reporting for conference abstracts, journal abstracts, and published articles.MethodsThis is a retrospective study of all 46 medical education research abstracts submitted to the Society of General Internal Medicine 2009 Annual Meeting that were subsequently published in a peer-reviewed journal. We compared MERSQI scores of the abstracts with scores for their corresponding published journal abstracts and articles. Comparisons were performed using the signed rank test.ResultsOverall MERSQI scores increased significantly for published articles compared with conference abstracts (11.33 vs 9.67; P < .001) and journal abstracts (11.33 vs 9.96; P < .001). Regarding MERSQI subscales, published articles had higher MERSQI scores than conference abstracts in the domains of sampling (1.59 vs 1.34; P = .006), data analysis (3.00 vs 2.43; P < .001), and validity of evaluation instrument (1.04 vs 0.28; P < .001). Published articles also had higher MERSQI scores than journal abstracts in the domains of data analysis (3.00 vs 2.70; P = .004) and validity of evaluation instrument (1.04 vs 0.26; P < .001).ConclusionsTo our knowledge, this is the first study to compare the quality of medical education abstracts and journal articles using the MERSQI. Overall, the quality of articles was greater than that of abstracts. However, there were no significant differences between abstracts and articles for the domains of study design and outcomes, which indicates that these MERSQI elements may be applicable to abstracts. Findings also suggest that abstract quality is generally preserved from original presentation to publication.

An instrument to assess the statistical intensity of medical research papers.

BackgroundThere is widespread evidence that statistical methods play an important role in original research articles, especially in medical research. The evaluation of statistical methods and reporting in journals suffers from a lack of standardized methods for assessing the use of statistics. The objective of this study was to develop and evaluate an instrument to assess the statistical intensity in research articles in a standardized way.MethodsA checklist-type measure scale was developed by selecting and refining items from previous reports about the statistical contents of medical journal articles and from published guidelines for statistical reporting. A total of 840 original medical research articles that were published between 2007–2015 in 16 journals were evaluated to test the scoring instrument. The total sum of all items was used to assess the intensity between sub-fields and journals. Inter-rater agreement was examined using a random sample of 40 articles. Four raters read and evaluated the selected articles using the developed instrument.ResultsThe scale consisted of 66 items. The total summary score adequately discriminated between research articles according to their study design characteristics. The new instrument could also discriminate between journals according to their statistical intensity. The inter-observer agreement measured by the ICC was 0.88 between all four raters. Individual item analysis showed very high agreement between the rater pairs, the percentage agreement ranged from 91.7% to 95.2%.ConclusionsA reliable and applicable instrument for evaluating the statistical intensity in research papers was developed. It is a helpful tool for comparing the statistical intensity between sub-fields and journals. The novel instrument may be applied in manuscript peer review to identify papers in need of additional statistical review.

P03.05: Characteristics of fetal heart beat (FHB)‐positive Caesarean scar pregnancy (CSP) and adverse effects of transarterial embolisation (TAE) therapy

Characteristics of fetal heart beat (FHB)-positive Caesarean scar pregnancy (CSP) depend on the development and prevalence of vaginal ultrasound, colour Doppler, and magnetic resonance imaging (MRI). This study aimed to identify FHB-positive CSP characteristics by reviewing cases that were previously reported in our country. We also aimed to determine adverse effects of transarterial embolisation (TAE) therapy. We searched articles using the key word “Caesarean scar pregnancy” from our national medical journal article retrieval system. We finally included 37 FHB-positive CSP cases and reviewed them. FHB-positive CSP was present at the following gestational weeks: one case at 5 weeks' gestation, 13 cases at 6, 13 cases at 7, four cases at 8, four cases at 9, and two cases at 10. FHB-positive CSPs were treated with feticide, drug therapy, blood supply-decreasing techniques and operation. Only drug therapy was performed in 12 cases. Uterine preservation procedures (vaginal, laparoscopic, hysteroscopic and laparotomic resection) were performed in 19 cases. Hysterectomy was performed in six cases. Some patients had adverse effects of TAE in this series. A patient was administered with local MTX and general MTX. Massive vaginal bleeding then appeared and TAE was performed. Abdominal hysterectomy was performed because of uterine rupture and intrauterine infection. There were some adverse effects in the succeeding pregnancies in two cases. In one report, the succeeding pregnancy after TAE therapy showed placenta accreta vera and uterine perforation. In another article, the authors reported uterine rupture in the succeeding pregnancy at 32 weeks of gestation. A total of 70% of cases of CSP appeared at 6 and 7 weeks of gestation. Only medical treatment was performed in 32% (12/37) of all patients. Operative uterine-preserving procedures were performed in 51% (19/37) of all patients. TAE had the possibility of some adverse effects in this CSP and succeeding pregnancies.

FRII-15 ‘EVOLUTION OF INNOVATION’: HISTORICAL PERSPECTIVES ON THE MANAGEMENT OF URETHRAL STRICTURE DISEASE

You have accessJournal of UrologyHistory of Urology: History Forum1 Apr 2017FRII-15 ‘EVOLUTION OF INNOVATION’: HISTORICAL PERSPECTIVES ON THE MANAGEMENT OF URETHRAL STRICTURE DISEASE Devang Desai, Pankaj Joshi, Hazem Orabi, Sandesh Surana, and Sanjay Kulkarni Devang DesaiDevang Desai More articles by this author , Pankaj JoshiPankaj Joshi More articles by this author , Hazem OrabiHazem Orabi More articles by this author , Sandesh SuranaSandesh Surana More articles by this author , and Sanjay KulkarniSanjay Kulkarni More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2464AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urethral stricture is a prevalent and challenging urological condition. Management has evolved over the last century, specifically with the advent of oral mucosal grafts for urethroplasty. We review the history of urethral stricture treatment. METHODS A literature search of medical texts, journal articles and historical texts was performed pertaining to history of urethral strictures. RESULTS Urethra originates from the Greek word ourein ‘urinate'. Urethral stricture was first depicted in Hindoo scriptures (6th century BC). Susruta described in Ayurveda the treatment by means of graduated dilators of metal or wood. Ambrose Pare in his depictions of urethrotomy mentions ‘A silver weir, sharp at the upper end, is to be passed in as far as the obstruction, then by oft thrusting it in and out, it may wear and make plain the resisting caruncles'. In 1894, Sapezho first used oral mucosa in urethroplasty. Humby revived the use in 1941. This landmark discovery revolutionized urethral surgery. Several modern innovations have since been described: staged repair (Johanson 1953), dorsal onlay (Barbagli 1996), ventral onlay (Morey, McAnnich 1996), dorsal inlay penile (Hayes and Malone1999), dorsal inlay bulbar (Asopa 2001), panurethral stricture management (Kulkarni 2000), nerve sparing and bulbospongiosus sparing bulbar reconstruction (Barbagli 2008), Enterourethroplasty (Mundy 2010), Non-transecting anastomotic urethroplasty (Mundy 2015). Over this period the perineal incision has evolved from a lamda to a midline incision. Current advances include liquid mucosal grafts; tissue engineering and stem cells, which would halt the process of fibrosis and prevent stricture formation. Posterior urethral injuries have traditionally been managed by anastomotic urethroplasty. Pierce 1962 performed total abdominal pubectomy. Paine & Coombs 1968 performed anastomotic urethroplasty after excision of scar by abdominal approach. 1973 Waterhouse developed abdominoperineal approach. 1976 Turner-Warwick used omental wrap for transpubic primary anastomosis. Webster & Goldwasser 1986 performed perineal anastomotic urethroplasty using inferior pubectomy. Kulkarni 2010 described etiology and management of posterior urethral injuries. Currently a progressive stepwise approach has been used for managing posterior urethral injuries. CONCLUSIONS Management of urethral stricture patients has evolved over the last century. The use of oral mucosal grafts is still one the greatest advancements. As we continue to better understand urethral strictures, we hope to make even greater strides over the next decade. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1072 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Devang Desai More articles by this author Pankaj Joshi More articles by this author Hazem Orabi More articles by this author Sandesh Surana More articles by this author Sanjay Kulkarni More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...